Blepharospasm is a kind of focal dystonia, an involuntary tightening of muscles around the eye. Dystonia is thought to be caused by faulty messages sent from the brain to the muscles. The result is that the eyes are unintentionally squeezed shut.


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If twitching in the face has reached the point where medical intervention is called for, botulinum toxin injections are the first-line of treatment.
What is Facial Spasm?
The facial muscles are very densely innervated, so that it’s usually possible to control the muscles of the face to a very fine degree.  Neurological disorders like blepharospasm or hemifacial spasm can deprive us of that control, resulting in considerable social embarrassment. 
Botulinum Injections for Facial Spasm
Both blepharospasm and hemifacial spasm can be treated with botulinum toxin.  In fact, this is one of the oldest medicinal uses of botulinum toxin, which was approved for the treatment of blepharospasm and hemisfacial spasm in 1989 by the US Food and Drug Administration (FDA).

Botox for Face or Eye Twitching

The human face is one of the most important areas of our bodies. We rely on our faces, and especially our eyes, to communicate with others. To really feel that we understand someone, we look them in the eye.

The facial muscles are very densely innervated, so that it’s usually possible to control the muscles of the face to a very fine degree. Neurological disorders like blepharospasm or hemifacial spasm can deprive us of that control, resulting in considerable social embarrassment.

Blepharospasm is a kind of focal dystonia, an involuntary tightening of muscles around the eye. Dystonia is thought to be caused by faulty messages sent from the brain to the muscles. The result is that the eyes are unintentionally squeezed shut. Although it is sometimes called benign essential blepharospasm, this term has fallen out of favor by many physicians because the condition is hardly “essential,” nor is it “benign.” While initially the contractions may be infrequent, the eyelid closure can progress, becoming more frequent, prolonged and forceful. In addition to being embarrassing, the condition impairs vision and can thereby make it difficult to do important everyday activities. In fact, about 12 percent of people with blepharospasm can be considered functionally blind. The spasms are often made worse by bright light, fatigue or stress, and disappear during sleep.

Hemifacial spasm is thought to result from irritation to the facial nerve near the base of the skull. This may be due to a blood vessel throbbing against the nerve. Unlike blepharospasm, in which the muscles around both eyes are affected, hemifacial spasm tends to cause periodic convulsions of just half of the face.

Both blepharospasm and hemifacial spasm can be treated with botulinum toxin. In fact, this is one of the oldest medicinal uses of botulinum toxin, which was approved for the treatment of blepharospasm and hemisfacial spasm in 1989 by the US Food and Drug Administration (FDA).

Botulinum toxin interferes with the neural signal normally used to tell a muscle to contract. It does this by stopping the neurotransmitter acetylcholine from being released from the end of the nerve. Acetylcholine normally tells the muscle to contract. Without that neurotransmitter being released, the signal is disrupted, the muscle relaxes, and the eye can open. The injections don’t cure the cause of the abnormal movement, but relieve the muscle spasm for about three to four months on average. In order for the effect to last, the injections need to be repeated periodically.

Approximately nine out of ten people with blepharospasm benefit from injection of low dose botulinum toxin into the muscles around the eyes. To treat blepharospasm, the botulinum toxin is injected into different areas in the orbicularis oculi. Side effects, such as double vision or droopy eyelids, are rare and tend to go away on their own.

Studies investigating the effectiveness of botulinum toxin in patients with hemifacial have described improvement in between 80 to almost 100 percent of patients.
The side of the face that is treated with botulinum toxin is often weak compared to the other side, but this weakness is usually mild and is felt to be outweighed by the benefits of the procedure. Some patients also describe dry eyes after treatment with botulinum toxin.

Overall, treatment with botulinum toxin for both blepharospasm and hemifacial spasm has been shown to be safe and effective. Furthermore, the procedure has existed for over two decades, and so is relatively well understood. If twitching in the face has reached the point where medical intervention is called for, botulinum toxin injections are the first-line of treatment.

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